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We evaluated the expression pattern of three selected miRNAs (miR-21, miR-155, and let-7a) to evaluate their potential roles by quantitative reverse transcription-polymerase chain reaction using formalin-fixed and paraffin-embedded tissues of 63 surgically resected pulmonary neuroendocrine (NE) tumors (19 typical carcinoids (TCs), 6 atypical carcinoids (ACs), 19 large cell NE carcinomas (LCNECs), and 19 small cell lung carcinomas (SCLCs). Control amplification for U6 small nuclear RNA (U6) Ceftiofur was performed in all samples. Normalized Ct values were calculated (CtExperimental miRNA-CtU6) for each case and recorded. The expression levels of miR-21 and miR-155 were significantly higher in high-grade NE carcinomas (LCNECs and SCLCs) than in carcinoid tumors (TCs and ACs) (each P < 0.001). The expression level of miR-21 in carcinoid tumors with lymph node metastasis was significantly higher than in carcinoid tumors without lymph node metastasis (P= 0.010). To the best of our knowledge, the present study is the first to examine the expression patterns of miR-21 and miR-155 as an adjunctive diagnostic tool or clinically relevant biomarkers for pulmonary NE tumors. Pulmonary neuroendocrine (NE) tumors form a distinct group of neoplasms that share characteristic morphologic, immunohistochemical, ultrastructural, and molecular features. Ceritinib clinical trial They span a clinical spectrum, from low-grade typical carcinoid (TC) and intermediate-grade atypical carcinoid (AC) to high-grade large cell NE carcinoma (LCNEC) and small cell lung carcinomas (SCLC).1 Currently, the 2004 World Health Organization (WHO) classification of pulmonary NE tumors is based on combined architectural patterns with the two most relevant parameters, the mitotic index and presence of necrosis, observed by hematoxylin and eosin (H&E) staining, for the purpose of recognizing the four different subtypes.2 However, they represent Caspase inhibitor in vivo a wide spectrum of phenotypically distinct entities, from which pulmonary NE tumors can sometimes be difficult to differentiate, even for an expert pathologist.3,4 Moreover, reproducible and objective pathologic criteria with clinical and prognostic value must be established when comparing the various grades of pulmonary NE tumors. With respect to the difficult issues surrounding the differential diagnosis of pulmonary NE tumors, we think that the molecular data has pathological and clinical relevance. Since only a few institutions have frozen tissue banks, most molecular studies of these tumors have been retrospective studies performed on formalin-fixed and paraffin-embedded (FFPE) tissue samples. Therefore, the type of molecular studies has been limited.